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Applied to the skin · Once a day
MelasmaTriple combinationShort course
A triple-combination prescription cream for melasma: hydroquinone 6% to slow pigment, tretinoin 0.025% to speed skin renewal and hydrocortisone 2.5% to calm irritation. Applied once at bedtime for a short course, usually up to 8 weeks.
Disclaimer: Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.
(hydroquinone 6% + tretinoin 0.025% + hydrocortisone 2.5%)
It follows the classic triple combination for melasma: hydroquinone slows melanin production, tretinoin speeds up skin renewal, and a corticosteroid calms the irritation the other two cause. Because of the tretinoin and the steroid, it is meant for a short course, not for continuous use, and it must not be used during pregnancy.
8 weeks
the usual course for a triple-combination cream
The FDA-approved triple combination for melasma is labeled for up to 8 weeks. Melasma often returns after stopping, so daily sunscreen and a gentler maintenance plan matter.
People with melasma who want the classic triple combination.
The three-ingredient approach dermatologists use: hydroquinone, tretinoin and hydrocortisone.
Up to eight weeks, then a maintenance plan. Not in pregnancy.
pigmentation will rebound without SPF 30+
results take weeks to months; patience essential
rare, with long continuous use; that is why it is used in courses
results continue refining; maintenance is ongoing
Week 1
Your physician assesses your pigmentation pattern and recommends the right strength. Start with the gentlest option; escalate if needed.
1Week 4–6
Fading usually starts to show. With the combinations, redness and peeling are common in these weeks.
2Month 2–3
The triple combination ends its course at about 8 weeks. Hydroquinone alone keeps fading the spots gradually.
3After the course
Your physician ends the course and plans the break and the maintenance. SPF 30+ daily, always.
4Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
This is the starting dose the pharmacy prints on the label. Your physician sets yours and adjusts it with you.
A sample week
Once a day
In clinical trials, triple-combination creams (hydroquinone, tretinoin and a corticosteroid) cleared or nearly cleared melasma in more patients than any of their ingredients alone.
The trade-off is irritation and sun sensitivity: redness, peeling and dryness are common in the first weeks. Used longer than prescribed, the steroid can thin the skin.
Learn moreThese creams contain hydroquinone and are prescription treatments. Do not use them if you are pregnant, trying to become pregnant or breastfeeding; the triple combination also contains tretinoin, which must not be used in pregnancy. Two of them contain hydrocortisone, a corticosteroid: used longer than prescribed it can thin the skin. Do not use them if you are allergic to hydroquinone, kojic acid or sulfites, and tell your physician if you have asthma. Apply only to the dark spots, never on broken or irritated skin, and keep away from the eyes and lips. Use a broad-spectrum SPF 30+ every day. Hydroquinone is used in courses with breaks: with long continuous use it can rarely cause ochronosis, a blue-black darkening of the skin. If the treated skin gets darker instead of lighter, stop and contact your physician. A new or changing mole or spot needs an in-person check, not a brightening cream.

1.Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.

2.Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.

3.Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.

Hydroquinone / tretinoin / hydrocortisone educational content reviewed by our physician
Scott Nass, MDDoctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
Applied to the skin, once a day, at bedtime. The starting prescription is 1 mL each time. Your physician sets your own dose and it is printed on your label.
Hydroquinone 6%, Tretinoin 0.025%, Hydrocortisone 2.5%.
1 tube at the starting strength, shipped to your door from a licensed US pharmacy.
Your physician decides with you. The triple combination works faster on stubborn melasma but irritates more and is limited to a short course; hydroquinone alone is gentler and is used in longer courses with breaks.
Long continuous use increases the risk of ochronosis, a blue-black darkening that is hard to reverse. Courses with breaks, set by your physician, keep the benefit and lower that risk. Creams with a corticosteroid or tretinoin have shorter courses.
Yes, but SPF protection becomes even more critical. Sun exposure reverses all progress and worsens melasma. Consider higher SPF (50+) and protective clothing in summer.
Rebound hyperpigmentation can occur if you discontinue hydroquinone abruptly or skip sun protection. Gradual tapering and consistent SPF prevent this. If darkening occurs, contact your physician.
Space them: hydroquinone or tretinoin at night, vitamin C or other actives in the morning, at least 12 hours apart. Avoid mixing hydroquinone with strong exfoliants until your skin adapts.
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The above statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Individual results vary.
Hydroquinone in melasma: efficacy, safety, and ochronosis risk with long-term use.
J Am Acad Dermatol, 2014Combination depigmenting therapies in melasma: a systematic review.
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